Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

Abstract

Introduction:The COVID-19 pandemic had an unprecedented effect on those living and working in care-homes for older people, as residents were particularly vulnerable to contracting the SARS-CoV-2 virus, associated with high morbidity and mortality. Often undervalued, care-home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID-19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. Objective: To explore RNs' experiences of working in older people's care-homes during the COVID-19 pandemic. Design: Qualitative interview study. Setting: Care-homes for older people in England and Scotland, UK. Methods: Recruitment via direct contact with care-homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of carehome, and location. Data collected through one-to-one online interviews using topic guide developed collaboratively with care-home nurses, focusing on how COVID-19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. Results: Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March-June 2021; majority aged 46-55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID-19.RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt

Health and care workers in long‐term care facilities and their role in preventing emerging infectious diseases: A scoping review

“…Nurses in nursing homes during the pandemic COVID -19 were not prepared for the exceptional situation (Birt et al, 2023).…”

“…Registered Nurses must consider the potential impact of future pandemics and disasters on care homes (Birt et al, 2023).…”

“…Nurses had to assess the severity of symptoms and then provide complex treatments to residents (Birt et al, 2023).…”

“…The limitations and uncertainty about the course of the disease, especially in the elderly, led nurses to report that they were providing care that did not meet their personal and professional standards (Birt et al, 2023).…”

“…Nurses who were working in care-homes were unprepared for the extraordinary situation they found themselves in during the COVID-19 pandemic, and this impacted their mental health and wellbeing (Birt et al, 2023).…”